IMPORTANT: Please type or print your answer

advertisement

San Beda College

College of Arts and Sciences

P.O. Box 4457 Manila 1099

Telefax: 7348062

Trunkline: 7356011 to 15 loc 3117

Website: www.sanbeda.edu.ph

(2 x 2)

APPLICATION FORM

IMPORTANT: Fill out this form with required information. Do not leave any item unanswered. Write “NA” if not applicable. Print this form and the 2 recommendation forms, put in a long brown envelope with all your credentials. THIS APPLICATION FORM SHOULD

BE COMPLETED SOLELY BY THE APPLICANT, OTHERWISE THE APPLICATION WILL

BE RENDERED NULL AND VOID.

PERSONAL AND FAMILY BACKGROUND

NAME ________________________________________________________________________________________

Print: Last First Middle Nickname

ADDRESS IN METRO MANILA ____________________________________________________________________

Tel/Fax/Cell/Email ______________________________________________________________________________

PERMANENT ADDRESS ________________________________________________________________________

Tel/Fax/Cell/Email ______________________________________________________________________________

DATE OF BIRTH __________________ PLACE OF BIRTH _________________ AGE _______ SEX __________

CITIZENSHIP _____________________ RELIGION _____________________ CIVIL STATUS ________________

SPOUSE (if applicable) _________________________________ Age _________ Occupation __________________

Are you living with your wife/spouse/children? ________ if no, please give details _____________________

NO. & NAMES/AGE OF CHILDREN (if applicable) ______________________________________________________

GENERAL HEALTH: (Encircle) Excellent/Good/Fair/Poor. State any peculiar disease or ailment that should be taken into consideration in planning your study program and daily activities (e.g., hearing, reading speech difficulties; physical

disabilities, allergies, emotional disturbances, etc. ) _____________________________________________________

NAME OF PHYSICIAN & TEL. NO. _________________________ DATE OF LAST PHYSICAL EXAM ___________

HAVE YOU EVER STOPPED OR BEEN FORCED TO STOP STUDYING FOR TWO WEEKS OR MORE?

YES NO. GIVE DETAILS AND DATES ________________________________________________

______________________________________________________________________________________________

IN CASE OF EMERGENCY, PLEASE CONTACT: (Give Full Name, Address, Tel. No. and relation) ______________

______________________________________________________________________________________________

FATHER MOTHER GUARDIAN

Living Deceased Living Deceased State your relationship

or affiliation with the

When? ___________ When? __________ guardian: __________________

Name ____________________________ ____________________________ _____________________________

Age ______________________________ ____________________________ _____________________________

Residence _________________________ ____________________________ _____________________________

Citizenship _________________________ ____________________________ _____________________________

Religion ___________________________ ____________________________ _____________________________

Occupation,

Position____________________________ ____________________________ _____________________________

Business

Address ___________________________ ____________________________ _____________________________

Contact No. ________________________ ____________________________ _____________________________

E-mail ____________________________ ____________________________ _____________________________

If your parents are both alive, are they living together? YES NO please give details:

Gross Monthly Family Income Below 10,000 10,000-30,000 31,000-50,000

51,000-70,000 above 70,000

Do you have relatives who are attending or have attended San Beda College ? Give names, relationship and if possible, dates of attendance: _____________________________________________________________________

EDUCATIONAL BACKGROUND

List in order, beginning from the lowest, ALL schools attended, including primary, intermediate and high school. If you have taken any courses above the high school level, list the college and/or professional school attended. This must be a COMPLETE listing of every school in which you have enrolled.

GRADE SCHOOL ADDRESS GRADE LEVEL YEARS

ATTENDED

HONORS

AWARDS

FROM – TO

__________________ _______________________ _______________ _______________ ____________

__________________ _______________________ _______________ _______________ ____________

__________________ _______________________ _______________ _______________ ____________

HIGH SCHOOL

__________________ _______________________ _______________ _______________ ____________

__________________ _______________________ _______________ _______________ ____________

COLLEGE (if you have attended any other college) or other VOCATIONAL/TECHNICAL SCHOOLS)

_______________________

_______________________

_______________

_______________

_______________

_______________

____________

____________

__________________

__________________

FINAL GRADE IN :

English

Math

Fourth Year H.S.

______________________

______________________

College Last Attended

(latest semester or 1 st semester, whichever is available)

______________________

______________________

List of Failing Grades and subjects college received in

_____________________

_____________________

Science

Gen. Average

______________________

______________________

______________________

______________________

_____________________

_____________________

STANDING IN GRADUATING CLASS: (Please encircle) Top 10%, 25% Lower 50% Repeater ____________

APPROXIMATE SIZE OF GRADUATING CLASS ________ DATE OF GRADUATION FROM H.S. ______________

CHECK ACTIVITIES IN WHICH YOU HAVE PARTICIPATED IN HIGH SCHOOL OR IN THE LAST SCHOOL

ATTENDED OR IN YOUR COMMUNITY:

_____ Religious Organizations

_____ Student Government

_____ Speech Contest

_____ Community Outreach

_____ Dramatics

_____ School Paper

_____ Glee Club/Chorale

_____ Athletics/Sports

_____ School Team

_____ Orchestra or Band

_____ None at all

_____ others

_____ Civic Action Groups _____ Dance Club ___________________________

Leadership Positions and organizations, at present (if any) ____________________________________________

SPECIAL TALENTS/SKILLS TRAINING _____________________________________________________________

HAVE YOU EVER BEEN DISMISSED OR PLACED ON PROBATION? _________ if yes, give the name of the school, the dates and the reason/s _______________________________________________________________

______________________________________________________________________________________________

Do you have any work experience? ______ If yes, please list (in a separate sheet) the details of your employment record, i.e., duration, employer, job description and position _______________________________________________

______________________________________________________________________________________________

HOW DID YOU COME TO KNOW ABOUT San Beda College ? Please check as applicable:

_____ from parents/sibling

_____ from my friends/classmates

_____ from my own initiative

_____ from teachers/classmates

_____ from the internet/webpage

_____ from SBC brochures/poster

_____ from Career Orientation talks

_____ others (pls. Specify)

_______________________

PROPOSED PROGRAM OF STUDY

Please check the degree program you intend to pursue.

Write 1 for your first choice and 2 for your second course choice

Degree Programs:

BS Accountancy

BS Economics and Public Policy

BS Entrepreneurship

BS Human Biology

BS Information and Communication Technology

BS Legal Management

BS Psychology

BSBA Financial Management

BSBA Human Resource Development Management

BSBA Marketing and Corporate Communications

BSBA Operations Management

TO BOTH THE APPLICANT AND PARENTS/GUARDIAN, PLEASE READ ALL CONTENTS BEFORE SIGNING

I HEREBY APPLY FOR ADMISSION TO THE COLLEGE OF ARTS AND SCIENCES, SAN BEDA COLLEGE. IF ADMITTED, I AGREE

TO ABIDE BY ITS REGULATIONS. I CERTIFY THAT THE FOREGOING INFORMATION AND THE CREDENTIALS SUBMITTED ARE

TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I FULLY REALIZE THAT OMISSION OR FALSIFICATION OF ANY

INFORMATION AND CREDENTIALS WILL BE CONSIDERED SUFFICIENT REASON FOR REJECTION OF THIS APPLICATION OR

FOR DISMISSAL, EVEN IF ALREADY ADMITTED.

________________________________________________

Full Name & Signature of Applicant

Date: __________________________________________

Attested By:

_______________________________________________________

Full Name & Signature of Parents/Guardian

Contact Nos. ____________________________________________

San Beda College

COLLEGE OF ARTS AND SCIENCES

P.O. Box 4457 Manila 1099

Telefax 734.8062 Trunkline 735.6011 loc 3117

Website: www.sanbeda.edu.ph

LETTER OF RECOMMENDATION

TO THE APPLICANT: Complete the information below and give this form, along with an envelope addressed to CAS

BOARD OF ADMISSIONS c/o ADMISSIONS CENTER, SAN BEDA COLLEGE, MENDIOLA,

MANILA to two (2) persons who know you well enough to provide an accurate recommendation, e.g., your class adviser, guidance counselor, or principal.

___________________________________________________________________________________ is applying for

Print: Last Name First Name Middle Name

Admission to the College of Arts and Sciences of San Beda for the ______ Semester of Academic Year ___________

TO THE REFERENCE: Please Complete this form and place it in the envelope provided by the student. Seal and sign the flap of the envelope. Envelopes which are unsealed and unsigned on the flap will not be accepted. You may omit any questions which you do not feel qualified to answer. All responses will be treated as strictly confidential.

A.

HOW LONG AND IN WHAT CAPACITY HAVE YOU KNOWN THE APPLICANT?

B.

ON A SCALE OF 1 TO 7, WITH 1 BEING POOR, 4 BEING AVERAGE, AND 7 BEING EXCEPTIONAL

HOW WOULD YOU RATE THE APPLICANT IN TERMS OF THE FOLLOWING? (If you feel you lack sufficient information to give an accurate answer, please check the column “x”)

PERSONAL CHARACTERISTICS

1. Mental Ability

2. Oral Communication Skills

Poor

1 2 3

Ave.

4 5 6

Exc.

7 x

3. Written Communication Skills

4. Study Habits and Attitudes

5. Influence and Leadership

6. Maturity

7. Concern for Others

8. Social and Emotional Adaptability

9. Conduct

10.Masculinity/Femininity (Physical & Behavioral

Manifestations)

C.

PLEASE INDICATE DATE OF ADMISSION AND LENGTH OF STAY OF THIS APPLICANT IN YOUR

SCHOOL.

D.

IN YOUR PROFESSIONAL JUDGMENT, WHAT RANK DOES THE APPLICANT BELONG TO IN

TERMS OF ACADEMIC PERFORMANCE? PLEASE PLACE A CHECK MARK IN THE BOX

CORRESPONDING TO THE RANK OF THE APPLICANT.

Top 10% 25% 50% Below 50% of his/her class/section

Top 10% 25% 50% Below 50% of senior/graduating class

Number of students in class/section _______________ in graduating class _____________

E.

SOME GIFTED INDIVIDUALS MAKE MEDIOCRE SCHOLASTIC RECORDS. IN YOUR OPINION IS THE

APPLICANT’S SCHOLASTIC RECORD AN ACCURATE INDEX OF HIS/HER ABILITY? IF NOT, PLEASE

EXPLAIN BRIEFLY

F.

PLEASE INDICATE BY CHECKING THE APPROPRIATE BOX BELOW IF THE APPLICANT HAS BEEN

PLACED ON PROBATION DURING HIS/HER STAY IN YOUR SCHOOL

G.

Academic Disciplinary Absences Please explain briefly________

________________________________________________________________________________________

________________________________________________________________________________________

PLEASE LIST ANY INFORMATION WHICH IN YOUR OPINION, WOULD BE HELPFUL TO THE ADMISSION

COMMITTEE. (e.g. Awards, Accomplishments, Talents, Weaknesses, Family Background, Interpersonal

Relationships, Perceptions of other people, extra sheet may be used, etc.)

H.

FROM YOUR OWN OBSERVATION AND AS ELICITED FROM FEEDBACK GIVEN BY OTHERS, WHAT ARE

THE ASPECTS OF HIS/HER SCHOOL PERFORMANCE AND PERSONALITY TRAITS THAT NEED

IMPROVEMENT.

I.

RECOMMENDATION:

I strongly recommend her/him for admission. I recommend him/her for admission with some reservations.

I recommend him/her for admission. I do not recommend him/her for admission.

SIGNATURE: ______________________________________________ Date: ____________________________________

NAME TYPED OR PRINTED: ___________________________________________________________________________

DESIGNATION/TITLE: _________________________________________________________________________________

INSTITUTION/ADDRESS: _______________________________________________________________________________

TEL/FAX NO./CELLPHONE: ____________________________________________________________________________

(Note: The CAS Board of Admissions may or may not contact you for confirmation of aforementioned data. Thank you)

Download